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Glucocorticoid therapy in neurologic critical care
Abstract
BACKGROUND: The pivotal role of inflammation and edema across the spectrum of central nervous system injury has driven extensive investigation into the therapeutic potential of glucocorticoids. OBJECTIVE: To review the experimental and clinical data relating to the efficacy and adverse effects of glucocorticoids in conditions encountered in critical neurologic and neurosurgical illness. DATA SOURCE: Search of MEDLINE and Cochrane databases, manual review of article bibliographies. DATA SYNTHESIS AND CONCLUSIONS: The efficacy of glucocorticoids is well established in ameliorating edema associated with brain tumors and in improving outcome in subsets of patients with bacterial meningitis. Despite frequently encouraging experimental results, clinical trials of glucocorticoids in ischemic stroke, intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, and traumatic brain injury have not shown a definite therapeutic effect. The evidence supporting glucocorticoid therapy for spinal cord injury is controversial; however methylprednisolone continues to be widely employed in this setting.
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“While there is widespread use of GCs in clinical neurology to control CNS inflammation in general and poststroke edema in particular, such interventions are often ineffective and can even worsen clinical outcome (Gomes et al., 2005).”
From The Stressed CNS: When Glucocorticoids Aggravate Inflammation (2009) · cites this paper as Gomes et al., 2005
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Tiebosch, I. A. (2012) · Utrecht University Repository (Utrecht University) · Cited by 1
Cross-talk between inflammatory cytokines and neural stem cells: a bidirectional relation
Grigoriadis, N., Lagoudaki, R., Tascos, N., & Milonas, I. A. (2007) · Future Neurology · doi:10.2217/14796708.3.1.39 · Cited by 1
Metadata
- Authors
- Gomes, J. A., Stevens, R. D., Lewin, J. J., Mirski, M. A., & Bhardwaj, A.
- Affiliations
- Johns Hopkins University (US)
- Venue
- Critical Care Medicine
- Published
- 2005-06
- Volume
- 33
- Issue
- 6
- Pages
- 1214-1224
- ISSN
- 0090-3493 (ISSN-L)
- OpenAlex
- W2073207619
- Cited by
- 118
- References
- 115
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 6 · 2017: 2 · 2016: 5 · 2015: 4 · 2014: 5 · 2013: 6 · 2012: 7
- FWCI
- 1.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (NS046379, R01NS046379)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- glucocorticoids, cerebral edema, inflammation, brain tumors, bacterial meningitis, ischemic stroke, intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, traumatic brain injury, spinal cord injury, methylprednisolone, adverse effects
- MeSH terms
- Brain Edema, Brain Neoplasms, Central Nervous System Diseases, Central Nervous System Infections, Cerebrovascular Disorders, Glucocorticoids, Humans, Myasthenia Gravis, Trauma, Nervous System
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